Comparative efficacy of thiazolidinediones and metformin for polycystic ovary syndrome

OBJECTIVE: To compare the efficacy of thiazolidinediones (TZDs) and metformin in polycystic ovary syndrome (PCOS) patients.

METHODS: This systematic review study was conducted at Shengjing Hospital of China Medical University, Shenyang, China between January and February 2012. We searched the following databases MEDLINE, EMBASE, the Cochrane Library, and Chinese National Knowledge Infrastructure until January 2012.

RESULTS: Six randomized controlled trials records involving 267 patients were retrieved. The effect of TZDs on body mass index (BMI) was significantly lower than metformin (p=0.001; standardized mean difference [SMD] = 0.40, 95% confidence interval [CI]; 0.16-0.65). The effect of TZDs on the Homeostasis Model of Assessment-Insulin Resistance Index was not significantly different from metformin (p=0.955, SMD = 0.01, 95% CI: -0.38-0.40). The effect of TZDs on the androgen level was not significantly different from metformin (serum total testosterone: p=0.287, SMD = 0.20, 95% CI: -0.17-0.57).

CONCLUSION: Compared to metformin, TZDs had the same effectiveness in treating insulin sensitivity and lowering androgen in PCOS patients, but the effect on weight loss was not as good as metformin.